Healthcare Provider Details

I. General information

NPI: 1780140830
Provider Name (Legal Business Name): EVA GEANETTE GONZALEZ CAREY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EVA GEANETTE GONZALEZ LMHC

II. Dates (important events)

Enumeration Date: 02/13/2019
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GROSSMAN DR STE 205
BRAINTREE MA
02184-4947
US

IV. Provider business mailing address

150 GROSSMAN DR STE 205 #6
BRAINTREE MA
02184-4947
US

V. Phone/Fax

Practice location:
  • Phone: 617-249-4955
  • Fax:
Mailing address:
  • Phone: 617-249-4955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: